Current situation of complications related to reconstructive surgery for pelvic organ prolapse: a multicenter study

Int Urogynecol J. 2021 Aug;32(8):2149-2157. doi: 10.1007/s00192-021-04892-x. Epub 2021 Jun 24.

Abstract

Introduction and hypothesis: This study aimed to investigate the evaluation and management of complications after pelvic floor reconstructive surgery for pelvic organ prolapse in China.

Methods: Complications of pelvic floor reconstructive surgery for pelvic organ prolapses from 27 institutions were reported from November 2017 to October 2019. All complications were coded according to the category-time-site system proposed by the International Urogynecological Association (IUGA) and the International Continence Society (ICS). The severity of the complications was graded by the Clavien-Dindo grading system. Four scales were used to evaluate patient satisfaction and quality of life after management of the complications: the Patient Global Impression of Improvement (PGI-I), the Pelvic Floor Impact Questionnaire Short Form (PFIQ-7), the Pelvic Organ Prolapse Symptom Score (POP-SS), and a 5-point Likert-type scale that evaluated the patient's choice of surgery.

Results: Totally, 256 cases were reported. The occurrence of complications related to transvaginal mesh (TVM) and laparoscopic sacrocolpopexy (LSC) had a significantly longer post-surgery delay than those of native tissue repair surgery (p < 0.001 and p = 0.010, respectively). Both PFIQ-7 and POP-SS score were lower after management of complications (p < 0.001). Most respondents (81.67%) selected very much better, much better, or a little better on the PGI-I scale. Only 13.3% respondents selected unlikely or highly unlikely on the 5-point Likert-type scale.

Conclusions: The occurrence of complications related to TVM surgery and LSC had a longer post-surgery delay than native tissue repair surgery. Long-term regular follow-up was vital in complication management. Patient satisfaction with the management of TVM complications was acceptable.

Keywords: Intraoperative complications; Pelvic organ prolapses; Postoperative complications; Transvaginal mesh.

Publication types

  • Multicenter Study

MeSH terms

  • Female
  • Gynecologic Surgical Procedures / adverse effects
  • Humans
  • Pelvic Organ Prolapse* / surgery
  • Plastic Surgery Procedures* / adverse effects
  • Postoperative Complications / etiology
  • Quality of Life
  • Retrospective Studies
  • Surgical Mesh / adverse effects
  • Surveys and Questionnaires
  • Treatment Outcome